US9737406B2 - Anatomically adapted orthopedic implant and method of manufacturing same - Google Patents

Abstract

An orthopedic implant to cover at least partially a surface of a bone of a patient. The orthopedic implant comprises a body having at least one retaining section, a bone-facing surface, and an articular surface. The at least one retaining section is configured to retain the orthopedic implant on the surface of the patient's bone along at least one axis by covering a corresponding retaining surface thereof. The bone-facing surface of at least one of the at least one retaining section nestingly conforms to an unresected portion of the surface of the bone of the patient. A method for conceiving and implanting an orthopedic implant is also provided.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the priority benefit of U.S. provisional application 62/017,933 filed on Jun. 27, 2014. This application is a continuation-in-part application of international application PCT/CA2014/050797 filed on Aug. 20, 2014, which claims the priority benefit of U.S. provisional application 61/868,236 filed on Aug. 21, 2013. U.S. provisional application 61/868,236, U.S. provisional application 62/017,933, and international application PCT/CA2014/050797 are hereby expressly incorporated by reference in their entirety.

FIELD OF THE INVENTION

The present invention relates to the field of orthopedic implants. More particularly, it relates to an anatomically adapted orthopedic implant with at least one retention section and a bone facing surface shaped to match a surface of a corresponding bone of a patient. The invention also relates to a method of manufacturing the same.

BACKGROUND

Prostheses are commonly used to repair and/or replace damaged bones and tissues in the human body. It is typical to repair diseased, injured or defective joints with standard off-the-shelf orthopedic implants (or prosthesis). However, standard off-the-shelf orthopedic implants usually do not fit on patient's existing or healthy biological structure. Therefore, patient's biological structure usually must be resected to fit the standard off-the-shelf orthopedic implant. For several reasons, resecting existing or healthy biological structure is not optimal and there is thus a need for patient's adapted orthopedic implants.

Furthermore, when implanting orthopedic implants, such as a femoral or a tibial orthopedic implant, it is typical to cut ligaments, such as anterior cruciate ligaments. Ligament cuts should however be minimized and, when possible, avoided.

In view of the above, there is a need for an improved anatomically adapted orthopedic implant and method of manufacture thereof which would be able to overcome or at least minimize some of the above-discussed prior art concerns.

SUMMARY OF THE INVENTION

According to a general aspect, there is provided an orthopedic implant to cover at least partially a surface of a bone of a patient. The orthopedic implant comprises a body having at least one retaining section, a bone-facing surface, and an articular surface. The at least one retaining section is configured to retain the orthopedic implant on the surface of the patient's bone along at least one axis by covering a corresponding retaining surface thereof and the bone-facing surface of at least one of the at least one retaining section nestingly conforms to an unresected portion of the surface of the bone of the patient.

In an embodiment, the bone-facing surface of the at least one retaining section is free of planar section.

In an embodiment, the at least one retaining section extends inwardly towards a center of the bone and at least one of upwardly and downwardly from a section covering an articular section of the surface of the bone.

In an embodiment, the bone-facing surface of the body is configured to nestingly conform to the surface of the bone of the patient. The bone-facing surface of the body can be configured to nestingly conform to a cartilage-free portion of the surface of the bone of the patient.

In an embodiment, the body is substantially C-shaped along at least one axis.

In an embodiment, the articular surface is conform to a cartilage portion of the surface of the bone of the patient.

In an embodiment, the articular surface is an offset of one of a cartilage portion of the surface of the bone of the patient and the surface of the bone of the patient.

In an embodiment, the articular surface is conform to a corrected cartilage portion of the surface of the bone of the patient.

In an embodiment, the orthopedic implant is a femoral implant.

In an embodiment, the orthopedic implant is a tibial implant.

According to another general aspect, there is provided a femoral orthopedic implant for implantation into a patient's femoral knee joint. The femoral orthopedic implant comprises a body being configured to be self-retaining along at least one axis and having a bone-facing surface, an articular surface and a retaining section. The bone-facing surface of the body nestingly conforms to a corresponding unresected and cartilage-free portion of a surface of a distal femur of the patient and the retaining section covers an unresected retaining surface of the distal femur of the patient.

In an embodiment, the bone-facing surface is a concave surface.

In an embodiment, the body is substantially C-shaped along at least one axis. Free ends of the body can define a restricted passage along a sagittal plane of the patient.

In an embodiment, the articular surface reproduces a cartilage portion of the femoral knee joint of the patient.

In an embodiment, the articular surface is an offset reproduction of one of a cartilage portion of the femoral knee joint of the patient and the surface of the distal femur of the patient.

In an embodiment, the articular surface is a corrected reproduction of a cartilage portion of the femoral knee joint of the patient.

In an embodiment, the bone-facing surface is free of planar section.

In an embodiment, the retaining section extends inwardly towards a center of the distal femur and upwardly from a section covering an articular section of the surface of the distal femur.

According to still another general aspect, there is provided a femoral orthopedic implant for implantation into a patient's femoral knee joint. The femoral orthopedic implant comprises a body having a bone-facing surface nestingly conforming to an entire corresponding unresected and cartilage-free portion of a surface of a distal femur of the patient.

In an embodiment, the bone facing surface is free of planar section.

In an embodiment, the body further comprises a retaining section covering a retaining surface of the distal femur of the patient to retain the femoral orthopedic implant onto the distal femur along at least one axis when implanted thereon. The retaining section can extend inwardly towards a center of the distal femur and upwardly from a section covering an articular section of the surface of the distal femur.

In an embodiment, the bone-facing surface is a concave surface.

In an embodiment, the body is substantially C-shaped along at least one axis. Free ends of the body can define a restricted passage along a sagittal plane of the patient.

According to a further general aspect, there is provided a tibial orthopedic implant for implantation into a patient's tibial knee joint. The tibial orthopedic implant comprises a body having a bone-facing surface, an articular surface and at least one retaining section, each one of the at least one retaining section covering a corresponding retaining surface of a proximal tibia of the patient and retaining the body along at least one axis and the bone-facing surface of at least one of the at least one retaining section nestingly conforming to an unresected portion of the surface of the proximal tibia of the patient.

In an embodiment, the bone-facing surface of the body nestingly conforms to a corresponding cartilage-free portion of a surface of a proximal tibia of the patient.

In an embodiment, the at least one of the at least one retaining section nestingly conforming to an unresected portion of the surface of the proximal tibia of the patient comprises a substantially U-shaped flange extending downwardly and inwardly towards the proximal tibia.

In an embodiment, the body comprises at least two retaining sections and wherein the bone-facing surface of at least one of the at least two retaining sections nestingly The at least two retaining sections can retain the body along at least two axes, perpendicular to one another.

In an embodiment, the articular surface reproduces a cartilage portion of the tibial knee joint of the patient.

In an embodiment, the articular surface is an offset reproduction of one of a cartilage portion of the tibial knee joint of the patient and the surface of the proximal tibia of the patient.

In an embodiment, the articular surface is a corrected reproduction of a cartilage portion of the tibial knee joint of the patient.

According to still another general aspect, there is provided a method for conceiving and implanting an orthopedic implant. The method comprises: obtaining an image of a structure of a patient's bone to be covered by the orthopedic implant; determining an unresected retaining surface on the structure of the patient's bone for the orthopedic implant; conceiving the orthopedic implant having a body with a bone-facing surface defining a retaining section nestingly conforming to the unresected retaining surface; and implanting the orthopedic implant on the structure of the patient's bone, the retaining section of the orthopedic implant covering the retaining surface of the structure of the patient's bone and retaining the orthopedic implant on the structure of the patient's bone along at least one axis.

In an embodiment, the unresected retaining surface is cartilage-free.

In an embodiment, the bone-facing surface of the retaining section is free of planar section.

In an embodiment, conceiving the orthopedic implant comprises conceiving the retaining section to extend inwardly towards a center of the bone and at least one of upwardly and downwardly from a section covering an articular section of the surface of the bone.

In an embodiment, conceiving the orthopedic implant comprises conceiving the bone-facing surface of the body to nestingly conform to the surface of the patient's bone.

In an embodiment, conceiving the orthopedic implant comprises conceiving the body to be substantially C-shaped along at least one axis.

According to another general aspect, there is also provided an implant for attachment to an implant region formed in remaining bone tissue following resection of a portion of a bone, the implant region having an application surface. The implant comprises: a body having a bone-facing surface abuttable against the application surface, an articulation plate engagement surface spaced apart from and opposite to the bone-facing surface, and an outer side surface extending between and connecting the bone-facing surface and the articulation plate engagement surface. The side surface has a side surface morphology matching an outer morphology of a corresponding surface of the resected portion of bone. The implant also comprises an attachment flange extending along at least a portion of the side surface and projecting away from the bone-facing surface along a longitudinal axis of the bone, the attachment flange defining an inner surface having an inner surface morphology matching an outer morphology of an outer surface of the bone for abutment thereagainst, the attachment flange having at least one hole extending transversely therethrough to receive an attachment device.

In an embodiment, the bone-facing surface includes at least one engagement member formed on the bone-facing surface along the longitudinal axis of the bone.

BRIEF DESCRIPTION OF THE DRAWINGS

Other objects, advantages and features will become more apparent upon reading the following non-restrictive description of embodiments thereof, given for the purpose of exemplification only, with reference to the accompanying drawings in which:

FIG. 1 is a rear perspective view of a bicompartmental femoral orthopedic implant implanted on a non-resected bone surface of a distal femur;

FIG. 2 is a front perspective view of the bicompartmental femoral orthopedic implant shown inFIG. 1, implanted on the non-resected bone surface of the distal femur;

FIG. 3 is a top perspective view of the bicompartmental femoral orthopedic implant shown inFIG. 1, removed from the distal femur;

FIG. 4 is a rear elevation view of the bicompartmental femoral orthopedic implant shown inFIG. 3;

FIG. 5 is a front elevation view of the bicompartmental femoral orthopedic implant shown inFIG. 3;

FIG. 6 is a side elevation view of the bicompartmental femoral orthopedic implant shown inFIG. 3;

FIG. 7 is a bottom plan view of the bicompartmental femoral orthopedic implant shown inFIG. 3;

FIG. 8 is a top plan view of the bicompartmental femoral orthopedic implant shown inFIG. 3;

FIG. 9, is a cross sectional schematic representation of a distal femur with a missing cartilage portion;

FIG. 10, is a cross sectional schematic representation of a distal femur with a missing cartilage portion and a missing bone portion;

FIG. 11 is a rear perspective view of a unicompartmental femoral orthopedic implant implanted on a non-resected bone surface of a distal femur;

FIG. 12 is a front perspective view of the unicompartmental femoral orthopedic implant shown inFIG. 11, implanted on the non-resected surface of the distal femur;

FIG. 13 is a top perspective view of the unicompartmental femoral orthopedic implant shown inFIG. 11, removed from the distal femur;

FIG. 14 is a front perspective view of a tibial orthopedic implant implanted on a partially resected medial bone surface of a proximal tibia;

FIG. 15 is a front exploded view of the tibial orthopedic implant and partially resected proximal tibia ofFIG. 14;

FIG. 16 is a rear perspective view of the tibial orthopedic implant shown inFIG. 14, implanted on the partially resected medial bone surface of the proximal tibia;

FIG. 17 is a rear exploded view of the tibial orthopedic implant and partially resected proximal tibia ofFIG. 16;

FIG. 18 is a top perspective view of the tibial orthopedic implant shown inFIG. 14, removed from the proximal tibia;

FIG. 19 is a side elevation view of the tibial orthopedic implant shown inFIG. 18;

FIG. 20 is a side elevation view of the tibial orthopedic implant shown inFIG. 18, and showing the opposed side ofFIG. 19;

FIG. 21 is a front elevation view of the tibial orthopedic implant shown inFIG. 18;

FIG. 22 is a bottom plan view of the tibial orthopedic implant shown inFIG. 18;

FIG. 23 is a top plan view of the tibial orthopedic implant shown inFIG. 18;

FIG. 24 is a front elevation view of a proximal tibia including two tibial orthopedic implants in accordance with an embodiment;

FIG. 25 is a top perspective view of a base plate of the tibial orthopedic implant in accordance with another embodiment;

FIG. 26 is a bottom perspective view of the base plate of the tibial orthopedic implant shown inFIG. 25;

FIG. 26A is a bottom perspective view of the base plate of the tibial orthopedic implant shown inFIG. 26 including fixation pegs according to an embodiment;

FIG. 26B is a bottom perspective view of the base plate of the tibial orthopedic implant shown inFIG. 26, according to an embodiment where the bone-facing surface is free of fixation pegs and has a surface pattern;

FIG. 26C is a bottom perspective view of the base plate of the tibial orthopedic implant shown inFIG. 26B, according to an embodiment where the surface pattern of the bone-facing surface has a different configuration;

FIG. 26D is a bottom perspective view of the base plate of the tibial orthopedic implant shown inFIG. 26B, according to an embodiment where the surface pattern of the bone-facing surface again has a different configuration;

FIG. 27 is a top plan view of the base plate of the tibial orthopedic implant shown inFIG. 25;

FIG. 28 is a bottom plan view of the base plate of the tibial orthopedic implant shown inFIG. 25;

FIG. 29 is a front perspective view of the base plate of the tibial orthopedic implant shown inFIG. 25, implanted on the partially resected medial bone surface of the proximal tibia; and

FIG. 30 is a front perspective view of the base plate of the tibial orthopedic implant shown inFIG. 25, implanted on the partially resected medial bone surface of the proximal tibia, according to an embodiment where the base plate includes a retaining rim and shown with an articulation plate connected thereto.

DETAILED DESCRIPTION

In the following description, the same numerical references refer to similar elements. The embodiments, geometrical configurations, materials mentioned and/or dimensions shown in the figures or described in the present description are embodiments only, given solely for exemplification purposes.

Moreover, although the embodiments of the anatomically adapted prosthesis, or orthopedic implant and corresponding parts thereof consist of certain geometrical configurations as explained and illustrated herein, not all of these components and geometries are essential and thus should not be taken in their restrictive sense. It is to be understood, as also apparent to a person skilled in the art, that other suitable components and cooperation thereinbetween, as well as other suitable geometrical configurations, can be used for the anatomically adapted orthopedic implant, as will be briefly explained herein and as can be easily inferred herefrom by a person skilled in the art. Moreover, it will be appreciated that positional descriptions such as “above”, “below”, “left”, “right” and the like should, unless otherwise indicated, be taken in the context of the figures and should not be considered limiting.

The present disclosure provides orthopedic implants (or prosthesis) which contribute to preservation of healthy bones, enhanced articular characteristics, and reduced impact on soft tissues such as ligaments.

In the disclosure, the term “proximal” refers to a direction generally located toward the center of the body and nearest the point of attachment to the body. By opposition, the term “distal” refers to a direction away from the center of the body. In other words, in reference with a patient, the term “proximal” refers to a direction generally towards the torso of the patient and “distal” refers to a direction opposite of proximal, i.e. away from the torso of the patient. The term “anterior” refers to a direction generally toward the front of a patient and “posterior” refers to the opposite direction of anterior, i.e. toward the back of the patient. In the context of an orthopedic implant alone, such directions correspond to the orientation of the orthopedic implant after implantation. Thus, for instance, the proximal portion of the orthopedic implant is the portion which will be closest to the torso of the patient.

Furthermore, the orthopedic implant can be referred to in the context of a coordinate system including transverse, coronal, and sagittal planes. Thus, upon implantation of the orthopedic implant a transverse plane of the orthopedic implant is generally parallel to the transverse plane of the patient, i.e. substantially horizontal. It is appreciated that, in some embodiments, upon implementation, the orthopedic implant planes can be slightly angled with respect to the corresponding anatomical planes.

Referring now to the drawings and, more particularly, referring toFIGS. 1 and 2, in accordance with one embodiment, there is provided an anatomically adapted bicompartmental femoralorthopedic implant20 for a femoral knee joint, i.e. an orthopedic implant designed to cover the lateral and medial femoral condyles by curving up around the distal end of the femur (or thighbone). More particularly, the bicompartmental femoralorthopedic implant20 is mounted to a distal surface of a patient's femur F. As will be described in more details below, the distal surface of the patient's femur F is non-resected before implanting the femoralorthopedic implant20 thereon, i.e. the femur bone is non-resected before implanting theorthopedic implant20.

Referring now toFIGS. 3 to 8, there is shown that the bicompartmental femoralorthopedic implant20 comprises abody22 with a bone-facingsurface24 and an articulatingsurface26, opposed to the bone-facingsurface24. In an embodiment, thebody22 of theimplant20 is made of a cobalt-chromium alloy. One skilled in the art will understand that, in alternative embodiments, thebody22 can also be made of other biocompatible materials.

Thebody22 has an overall C-shaped profile. It includes ananterior flange28 and two spaced-apartcondyles34,36. In the embodiment shown, the bone-facingsurface24 is free of fixation pegs, as will be described in more details below.

In an embodiment, the bone-facingsurface24 is configured to be complementary to a portion of a patient's bone surface and nestingly conform thereto when engaged therewith. In other words, the bone-facingsurface24 is patient specific and can mate with the portion of the patient's bone surface in only one position. For instance, in the embodiment shown inFIGS. 1 to 8, the bone-facingsurface24 of the bicompartmental femoralorthopedic implant20 matches entirely the surface of the distal end of the patient's femur F, without resection thereof. Therefore, it will be understood by a person skilled in the art that the shape of the bone-facingsurface24 will vary in accordance with the shape of the patient's bone.

In view of the above, it will be understood that in order to design the bicompartmental femoralorthopedic implant20, including the bone-facingsurface24, an image of at least a portion of a body structure of the patient is previously obtained. The image of at least the portion of the body structure of the patient includes the bone on which theorthopedic implant20 is to be implanted.

The image can be obtained using known imaging techniques, such as, without being limitative, magnetic resonance imaging (MRI), computed axial tomography (CAT scan), ultrasound, X-ray, or the like and various CAD software for the three-dimensional image reconstruction. Once the image of at least the portion of the patient body structure has been obtained, the patient-specificorthopedic implant20 is designed and conceived. Theorthopedic implant20 is conceived with an orthopedic implant conception software. The bone-facingsurface24 is designed to fit the shape of the bone when the imaging of the patient body structure is carried out. The articulatingsurface26 is also designed to be specific to the patient and can be designed to compensate for deficiencies, as will be described in more details below.

In the embodiment shown, the bone-facingsurface24 of theorthopedic implant20 is planar surface free since it conforms to the shape of a non-resected bone.

The bone-facingsurface24 is designed to be juxtaposed to a section of the patient's bone. Thus, the bone-facingsurface24 is designed to be juxtaposed and nestingly conform to the outer surface of the bone when the imaging of the patient's body structure is carried out. Thus, if a section of the bone is broken (seeFIG. 10), the bone-facingsurface24 is designed to compensate or correct the missingbone portion38. The bone-facingsurface24 will be designed to follow the outer surface of the patient's bone, including the missingbone portion38, if any. The bone-facingsurface24 is thus adapted to the shape of the bone when the imaging is carried out. The bone-facingsurface24 is free of planar sections, but rather reproduces the corresponding cartilage-free external surface of the bone. In an embodiment, thebone facing surface24 can include patterns or features formed therein in order to favor the retention of theimplant20. For example and without being limitative, the patterns can include micro-patterns such as micro-grooves formed on thebone facing surface24 in order to help the retention of theimplant20 on the bone by osteointegration. In another embodiment, other types of patterns or features favoring the retention of theimplant20 on the bone can be used. The patterns can be formed on a section of thebone facing surface24 or the entire surface thereof.

The shape of the articulatingsurface26, opposed to thebone facing surface24, is typically designed to reproduce the outer shape of the cartilage C, which is superposed to the bone, when the imaging is carried out. Once again, however, if part of the cartilage C covering the bone is missing or broken (seeFIGS. 9 and 10), for instance if the patient has osteoarthritis, when the imaging of the patient's body structure is carried out, the articulatingsurface26 is designed to compensate or correct the missingcartilage portion39. Therefore, the thickness of the orthopedic implant can be variable with the orthopedic implant being thicker in sections where the cartilage C and/or the bone is missing or broken. In view of the above, the articulatingsurface26 can be a reproduction or a corrected reproduction of the cartilage C covering the bone. In an alternative embodiment, the shape of the articulatingsurface26 can also be an offset of the corresponding outer surface of the patient's bone.

Furthermore, the shape of the articulatingsurface26 can also be adjusted to correct defaults, for example and without being limitative in the mechanical axis of the patient's leg. Such corrections can be implemented to modify the patient's walking. The correction can be determined by a surgeon according to desired correction parameters. In an alternative embodiment, the articulating surface can also be adjusted in order to increase the thickness between thebone facing surface24 and the articulatingsurface26, uniformly or non-uniformly, for example and without being limitative when theimplant20 is required to have a minimum thickness that is greater than the thickness of the cartilage. Thus, it will be understood that the design of the orthopedic implants can follow two different patterns. First, the shape of the bone-facingsurface24 can follow the shape of the patient's bone, including broken bone sections, when imaging is carried out and the articulatingsurface26 can reproduce the shape of the patient's cartilage when imaging is carried out. Second, the shape of the bone-facingsurface24 can follow the shape of the patient's bone, including broken bone sections, when imaging is carried out, and the articulatingsurface26 can be based on the shape of the patient's cartilage when imaging is carried out but also compensate for broken or missing cartilage sections and/or modified to correct defaults (corrected reproduction) or reach a minimum thickness.

As shown inFIGS. 1 to 8, the femoralorthopedic implant20 is self-retaining along at least one axis. In the embodiment shown, the bi-compartmental femoralorthopedic implant20 has a C-shaped profile, in cross-section, with the free ends defining a restricted passage along the sagittal plane. Thus, when implanted on the distal femur F, the C-shaped profile of theorthopedic implant20 creates a retainingsection30 which covers a corresponding retaining surface, i.e. the distal femoral condyle, of the distal femur F and thereby restrains the movement of the femoralorthopedic implant20 along the sagittal plane, i.e. from the anterior side to the posterior side and vice-versa, as well as vertically, i.e. along an axis perpendicular to the transverse plane. As mentioned above, the entire bone-facingsurface24 follows the shape of the bone to which it is secured and is free of planar sections. In the embodiment shown, the retainingsection30 extends upwardly from a section covering the articulation section of the distal femur and covers the femoral condyles, which define at least part of the retaining surface.

The femoralorthopedic implant20 comprises an articular section designed to cover an articular surface of the distal femur F. The retainingsection30 extends inwardly, towards a center of the distal femur F, upwardly from the section covering the articular surface of the distal femur F.

As can be seen inFIGS. 3 to 8, the bone-facingsurface24 of the bicompartmentalorthopedic implant20 is free of fixation pegs. As will be understood, the configuration of theimplant20, with the retainingsection30, is such that theimplant20 can be stably implanted on the distal femur F without the use of fixation pegs. In the illustrated embodiment ofFIGS. 1 and 2, the bicompartmentalorthopedic implant20 is anchored to the distal femur F by two screws35 (only one is shown) preventing movement of theimplant20 along the unrestrained axis(es). In an alternative embodiment, more or less than two screws can also be used. One skilled in the art will understand that in another alternative embodiment, other known anchoring methods, such as, without being limitative, cementing, can be used for anchoring theimplant20 to the distal femur F. In an embodiment, mechanical fasteners such as screws can be used in combination with adhesive such as cement based adhesive. In another alternative embodiment, osteointegration can also be used to anchor theimplant20.

In order to manufacture the bicompartmentalorthopedic implant20, as mentioned above, an imaging step of the patient's body structure is first carried out and a three-dimensional image reconstruction of the patient's body structure is performed. The image is analysed to determine the retaining surface on the structure of the patient's condyle for the orthopedic implant. The femoralorthopedic implant20 is subsequently designed and conceived with the bone-facingsurface24 following the shape of the distal femur F of the patient, includingbroken bone sections38 and a retainingsection30 conforming to the retaining surface. The articulatingsurface26 is designed based on the shape of the patient's cartilage when imaging is carried out. As mentioned above, the articulatingsurface26 can also compensate for missingcartilage portions39 and/or be modified to correct defaults. As mentioned, the femoralorthopedic implant20 is conceived to be superposed to the distal femur F of the patient in a single position.

When implanting the bicompartmental femoralorthopedic implant20, the cartilage covering the bone is first removed. The bicompartmental femoralorthopedic implant20 is subsequently engaged over the distal femur F. In the embodiment shown, a rotation movement is typically carried out for engaging the femoralorthopedic implant20 over the distal femur, the retainingsection30, being firstly engaged over the corresponding retaining surface of the femur F and the femoralorthopedic implant20 being subsequently pivoted in place. In the embodiment shown, the retainingsection30 is first engaged over the femoral condyles and, then, theorthopedic implant20 is pivoted to engage and cover the anterior portion.

Thus, implantation of theorthopedic implant20 does not require femoral resection. The bone-facingsurface24 follows the shape of the distal femur F when imaging is carried out prior to surgery. Furthermore, the thickness of theorthopedic implant20 and, thereby, the shape of the articulatingsurface26 can be modified in specific sections thereof to correct bone defaults and orthopedic defaults determined by the surgeon. In an embodiment, the modification of the articulating surface is an offset of the shape of the patient's cartilage C when imaging is carried out.

When the surgeon implants the femoralorthopedic implant20 onto a patient, the design of thefemoral implant20 does not require cutting the anterior cruciate ligaments, as it often occurs with standard off-the-shelf prosthesis.

Referring now toFIGS. 11 to 13, there is shown an alternative embodiment of an anatomically adapted orthopedic implant, wherein the features are labelled in the 100 series and which correspond to the reference numerals of the previous embodiment. In accordance with this alternative embodiment, there is provided a unicompartmental femoral orthopedic implant120 (having a single condyle134). In this embodiment, the distal surface of the patient's femur F is once again non-resected before implanting the femoralorthopedic implant120 thereon.

It will be appreciated that the unicompartmental femoralorthopedic implant120 has similar characteristics as the previously described bicompartmental femoralorthopedic implant20 regarding the shape of the bone-facingsurface124 and the articulatingsurface126 of the body122. In other words, the bone-facingsurface124 is also configured to be complementary to a portion of a patient's bone surface and nestingly conform thereto when engaged therewith. It can also be designed to compensate or correct a missing or broken bone portion. The articulatingsurface126 is also typically designed to reproduce the outer shape of the cartilage, which is superposed to the bone, or represent an offset of the patient's bone when imaging is carried out. It can be designed to compensate or correct missing cartilage portion, or defaults, for example in the mechanical axis of the patient's leg.

Moreover, the unicompartmental femoralorthopedic implant120 is also self-retaining along at least one axis, as it includes aretaining section130 which covers a corresponding retaining surface of the distal femur F. Similarly to the bicompartmentalorthopedic implant20, in the embodiment ofFIGS. 11 to 13, theimplant120 has a C-shaped profile, in cross-section, with the free ends defining a restricted passage along the sagittal plane and thereby restraining the movement along the sagittal plane, as well as vertically, i.e. along an axis perpendicular to the transverse plane, when implanted. The bone-facingsurface124, including theretaining section130, is free of planar sections as it reproduces the corresponding cartilage-free external surface of the bone.

Similarly to the bicompartmentalorthopedic implant20, the unicompartmental femoralorthopedic implant120 is designed to partially cover an articular surface of the distal femur F. The retainingsection130 extends inwardly, towards a center of the distal femur F, upwardly from the section covering the articular surface of the distal femur F.

The bone-facingsurface124 of the unicompartmental femoralorthopedic implant120 is also free of fixation pegs and theimplant120 can be anchored to the distal femur F by the above described means, such as, for example, ascrew135.

One skilled in the art will understand that, even though the unicompartmental femoralorthopedic implant120 shown inFIGS. 11 to 13, is designed to be implanted on the medial femoral condyle of a patient, in an alternative embodiment, it can be designed to be implanted on a lateral femoral condyle of a patient. In another alternative embodiment, unicompartmental femoralorthopedic implants120 can be implanted on the medial femoral condyle and the lateral femoral condyle to form a bicompartmental (or total) implant where the compartments are not joined to one another.

In another embodiment (not shown), the bicompartmental femoral orthopedic implant can include two implant components configured in an adjacent configuration, each one of the implant components covering a respective one of the medial femoral condyle and the lateral femoral condyle. In one embodiment, the two implant components can be configured in an adjacent and contiguous configuration. In another configuration, the two implant components can be configured in an adjacent and partially overlapping configuration wherein an edge region of one of the two implant components at least partially overlaps the edge region of the other one of the two implant components. In an embodiment, the two implant components can be secured together and to the bone with one or more fastener having a head, such as a suitable screw. The head can be designed to at least partially abut on both implant components, with the fastener extending through the bone. The implant components can include a recess defined in their articular surface in which the head can be received. Thus, an upper surface of the head of the fastener can be substantially leveled with the articular surface of the two implant components. Moreover, a portion of the two implant components extends between the fastener head and the bone, thereby securing the two implant components to the bone.

Referring now toFIGS. 14 to 24, there is shown another alternative embodiment of an anatomically adapted orthopedic implant, wherein the features are labelled in the 200 series and which correspond to the reference numerals of the previous embodiments.

In accordance with this alternative embodiment, there is provided a tibialorthopedic implant220 for a tibial knee joint. The tibialorthopedic implant220 is implanted on a partially resected bone surface (or implant region) of a medial section of a proximal tibia T. As will be described in more details below, the proximal surface of the patient's tibia T is partially resected prior to the implantation of the tibialorthopedic implant220 thereon.

The tibialorthopedic implant220 comprises abody222 with a bone-facing surface224 (or contact surface) and an articulating surface226 (or receiving surface), opposed to the bone-facingsurface224.

In an embodiment, thebody222 includes abase plate240 and anarticulation plate242 connectable to thebase plate240. Thebase plate240 includes the bone-facing surface224 (FIG. 20) and an opposed articulationplate engagement surface225. Thearticulation plate242 includes the articulatingsurface226 and an opposed baseplate engagement surface227. The articulationplate engagement surface225 of thebase plate240 and the baseplate engagement surface227 of thearticulation plate242 are complementary in shape to allow thearticulation plate242 to be secured to thebase plate240, following the implantation of thebase plate240 on the tibia T of the patient. For example and without being limitative, the articulationplate engagement surface225 of thebase plate240 and the baseplate engagement surface227 of thearticulation plate242 can comprise complementary male-female assemblies allowing the secure engagement of thearticulation plate242 to thebase plate240.

In an embodiment, thebase plate240 is made of a cobalt-chromium alloy while thearticulation plate242 is made of biocompatible plastic such as high-molecular-weight polyethylene (HMWPE), ultra-high-molecular-weight polyethylene (UHMWPE), Polyether ether ketone (PEEK), or the like. One skilled in the art will understand that, in an alternative embodiment, thebody222 of the tibialorthopedic implant220 can be a single piece where thebase plate240 and thearticulation plate242 are joined to form an integral component.

Thebase plate240 also includes anouter side surface229 forming the exposed outer face of theimplant220. Theouter side surface229 extends between the bone-facingsurface224 and the articulationplate engagement surface225, thereby connecting the two together. Theside surface229 has a side surface morphology, which is the form and structure of theside surface229. The side surface morphology matches the outer morphology of the corresponding surface of a tibial portion which was removed from the tibia during the resection thereof. The term “matches” or “matching” is used herein to describe the relationship between morphologies and refers to the similarity between these surface profiles, in that both morphologies substantially correspond. This is better appreciated by explaining how the side surface morphology may be generated, according to an embodiment.

In an embodiment, prior to inserting theimplant220, a scan of the portion of the tibia T to be resected is performed. The scan provides information (data) regarding the contour, shape, and profile of the outer surface of the Tibia T which theimplant220 is intended to replace. This information can be used to design the side surface morphology of the side surface229 (as well as other exterior surfaces) such that theimplant229 can be considered custom designed to the specific patient in which it will be implanted. When theimplant220 is manufactured, the side surface morphology can be applied to theside surface229, thereby producing a patient-specific implant220. It will be appreciated that such a side surface morphology helps to mimic the resected portion of the Tibia T, and can further help integration of theimplant220 with the bone. The matching morphologies also help theimplant220 to better mate with the bone, thereby allowing for better cooperation between theimplant220 and the bone.

In an embodiment, the bone-facingsurface224 of thebase plate240 is once again configured to be complementary to a portion of a patient's bone surface and nestingly conform thereto when engaged therewith. However, given that the tibialorthopedic implant220 is designed to be implanted on a partially resected tibia T, sections of the bone-facingsurface224 are configured to match a resected bone section (or application surface of the implant region). Once again, in an embodiment, thebone facing surface224 can include patterns such as the one described above in reference to the femoral orthopedic implant. Exemplary embodiments of such patterns are discussed below with reference toFIGS. 26B to 26D.

In the illustrated embodiment, and as better seen inFIGS. 15, 17 and 20 to 22, the bone-facingsurface224 has a transverseplanar section250 extending along a transverse axis defined by a medial plateau254 (application surface) formed in the proximal tibia T by the partial resection thereof. The transverseplanar section250 is configured to be juxtaposed and fit onto themedial plateau254. The bone-facingsurface224 also has a sagittalplanar section252 extending along a sagittal axis defined by amedial wall256 also formed in the proximal tibia T by the partial resection thereof. The sagittalplanar section252 is configured to be juxtaposed and fit onto themedial wall256. The angle between the transverseplanar section250 and the sagittalplanar section252 therefore corresponds to the angle formed between themedial plateau254 and themedial wall256, in order to provide a precise fit of thebase plate240 on the partially resected proximal tibia T.

In an embodiment, the angle between themedial plateau254 and themedial wall256 is an acute angle, themedial wall256 being vertically inclined towards themedial plateau254. In such an embodiment, the angle between the transverseplanar section250 and the sagittalplanar section252 is therefore a corresponding acute angle. In an embodiment, the angle between the transverseplanar section250 and the sagittalplanar section252 ranges between 75 and 89 degrees. As will be described in more details below, in an alternative embodiment themedial plateau254 and themedial wall256 can be perpendicular and thereby form a right angle. In such an embodiment, the angle between the transverseplanar section250 and the sagittalplanar section252 would be a corresponding right angle. In another alternative embodiment, themedial plateau254 and themedial wall256 can form an obtuse angle, for example and without being limitative due to physiological restrictions of the patient for performing the resection, the angle between the transverseplanar section250 and the sagittalplanar section252 being a corresponding obtuse angle.

Still referring toFIGS. 15, 17 and 20 to 22, thebase plate240, further includes a substantially U-shaped flange258 (or attachment flange) extending downwardly and inwardly from the periphery of the transverseplanar section250. In an embodiment, theflange258 covers the periphery of the transverseplanar section250, outside of themedial wall256. One skilled in the art would however understand that, in an alternative embodiment, theflange258 can cover only a portion of the periphery of the transverseplanar section250 outside of themedial wall256. In an embodiment, theflange258 can include a plurality of spaced-apart flange sections defining together a substantially U-shaped profile. The internal surface260 (or abutment surface) of theflange258 is patient specific and is part of the bone-facingsurface224 as it is configured to mate with the corresponding portion of the patient's bone surface.

As can be seen inFIGS. 14 to 17, theinternal surface260 of theflange258 matches the contour of the proximal tibia T of the patient, around the resectedmedial plateau254. Therefore, the shape of theinternal surface260 of theflange258 varies in accordance with the shape of the patient's bone.

Therefore, similarly to the above described implants, the design of the tibialorthopedic implant220 is based on an image of at least a portion of the body structure of the patient, including the tibia T.

The bone-facingsurface224 is designed with theflange258 having aninternal surface260 fitting the cartilage-free outer surface of the bone when the imaging of the patient body structure is carried out. The transverseplanar section250 and the sagittalplanar section252 are designed to fit the resected portions of the bone subsequently to a partial resection thereof.

As shown more clearly inFIGS. 15 and 17, the tibialorthopedic implant220 is once again self-retaining along at least one axis. In the embodiment shown, the movement of the tibialorthopedic implant220 is restrained along the sagittal plane, i.e. along an axis extending from the anterior side to the posterior side and vice-versa, as well as vertically, i.e. along an axis extending perpendicular to the transverse plane, when implanted. The restriction of the movement of the tibialorthopedic implant220 results from the combination of theflange258 projecting inwardly towards the corresponding section of the tibia T (thereby forming afirst retaining section230 covering afirst retaining surface231 of the tibia T) and the acute angle between the transverseplanar section250 and the sagittalplanar section252 matching the acute angle between themedial plateau254 and the medial wall256 (thereby forming asecond retaining section232 covering asecond retaining surface233 of the tibia T). Thefirst retaining section230 restrains movement of theorthopedic implant220 along the sagittal plane as well as vertically. Thesecond retaining section232 restrains movement of theorthopedic implant220 vertically only.

One skilled in the art will therefore understand that, in an alternative embodiment, the above-described restriction of the movement of the tibialorthopedic implant220 along the sagittal plane as well as vertically can be achieved by providing thefirst retaining section230 formed by theflange258 projecting inwardly towards the corresponding section of the tibia T only. In other words, thesecond retaining section232 provided by themedial wall256 and resulting from the acute angle between the transverseplanar section250 and the sagittalplanar section252 matching the acute angle between themedial plateau254 and themedial wall256 provides optional increased support to restrain the movement of the tibialorthopedic implant220 vertically.

The tibialorthopedic implant220 is designed to partially cover an articular surface of the proximal tibia T. For the tibialorthopedic implant220, the articular surface is resected and includes themedial plateau254. Thefirst retaining section230 extends inwardly, from the peripheral edge of the transverseplanar section250, towards a center of the proximal tibia T, downwardly from the transverseplanar section250 covering the articular surface of the proximal tibia T.

The bone-facingsurface224 of thefirst retaining section230 is free of planar sections, but rather reproduces the corresponding cartilage-free external surface of the bone.

As can be seen inFIGS. 20 to 22, the bone-facingsurface224 of the tibialorthopedic implant220 is once again free of fixation pegs and directly matches the corresponding faces of the resected and non-resected sections of the proximal tibia T.

Now referring toFIG. 24, one skilled in the art will understand that even though the above description ofFIGS. 14 to 23 referred to a single tibialorthopedic implant220 for a medial section of a proximal tibia T, in an embodiment where a bicompartmental (or total) knee surgery is performed, tibialorthopedic implants220 can be provided on the medial and lateral sections of the proximal tibia T of a patient. Moreover, in an alternative embodiment (not shown), a single tibialorthopedic implant220 for a lateral section of a proximal tibia T, can also be provided.

Referring now toFIGS. 25 to 29, there is shown another alternative embodiment of an anatomically adapted orthopedic implant and, more particularly, a tibialorthopedic implant320 for a tibial knee joint, wherein the features are labelled in the 300 series and which correspond to the reference numerals of the previous embodiments. As for the above described tibialorthopedic implant220, the tibialorthopedic implant320 is conceived to be implanted on a partially resected bone surface of a medial section of a proximal tibia T. However, the shape and configuration of the retaining sections and the shape and configuration of the articulationplate engagement surface325 of thebase plate340 are different than those of the above described tibialorthopedic implant220.

Similarly to the above described implants, the design of the tibialorthopedic implant320 is based on an image of at least a portion of the body structure of the patient, including the tibia T.

The tibialorthopedic implant320 comprises abase plate340 and an articulation plate. In the figures, solely thebase plate340 of thebody322 is shown. Thebase plate340 is designed to be engageable with the articulation plate (not shown). Thebase plate340 includes the bone-facing surface324 (FIG. 26) and an opposed articulationplate engagement surface325. The articulationplate engagement surface325 of thebase plate340 is designed to be complementary in shape to the base plate engagement surface of the articulation plate.

In an embodiment, the bone-facingsurface324 of thebase plate340 is once again configured to be complementary to a portion of a patient's bone surface and nestingly conform thereto, when engaged therewith. More particularly, the bone-facingsurface324 of the tibialorthopedic implant320 comprises sections configured to match a resected bone section and sections configured to match an unresected bone section. Once again, in an embodiment, thebone facing surface324 can include patterns such as the one described above in reference to the femoral orthopedic implant.

As the bone-facingsurface224, the bone-facingsurface324 has a transverseplanar section350 configured to be juxtaposed and fit onto the medial plateau of the resected tibia T and a sagittalplanar section352 configured to be juxtaposed and fit onto themedial wall356 of the resected tibia T.

Thebase plate340 includes a substantiallyU-shaped flange358 extending downwardly and inwardly from the periphery of the transverseplanar section350. In the embodiment shown, theflange358 covers only a portion of the periphery of the transverseplanar section350 outside of themedial wall356. In another embodiment, theflange358 can cover the entire periphery of the transverseplanar section350, outside of themedial wall356. Theinternal surface360 of theflange358 is patient specific and is part of the bone-facingsurface324 as it is configured to mate with the corresponding portion of the patient's bone surface. Thus, theinternal surface360 of theflange358 matches entirely and nestingly conforms to the contour of the proximal tibia T of the patient, around the resected medial plateau354. Therefore, the shape of theinternal surface360 of theflange358 varies in accordance with the shape of the patient's bone and fits the cartilage-free outer surface of the bone when the imaging of the patient body structure is carried out.

The tibialorthopedic implant320 is once again self-retaining along at least one axis. The movement of the tibialorthopedic implant320 is restrained partially along the sagittal plane, i.e. from the anterior side to the posterior side and vice-versa, as well as vertically. As for the tibialorthopedic implant220, the restriction of the movement of the tibialorthopedic implant320 results from the combination of theflange358 projecting inwardly towards the corresponding section of the tibia T (thereby forming afirst retaining section330 covering a first retaining surface of the tibia T) and the acute angle between the transverseplanar section350 and the sagittalplanar section352 matching the acute angle between the medial plateau354 and the medial wall356 (thereby forming asecond retaining section332 covering asecond retaining surface333 of the tibia T). Thefirst retaining section330 restrains movement of theorthopedic implant320 partially along the sagittal plane as well as vertically. Thesecond retaining section332 restrains movement of theorthopedic implant320 vertically only.

The bone-facingsurface324 of thefirst retaining section330 is free of planar sections, as it reproduces the corresponding cartilage-free external surface of the bone.

Similarly to the above described tibialorthopedic implant220, the tibialorthopedic implant320 is designed to partially cover a resected articular surface of the proximal tibia T, including the medial plateau. The retainingsection330 extends inwardly, from the peripheral edge of transverseplanar section350, towards a center of the proximal tibia T, downwardly from the transverseplanar section350 covering the articular surface of the proximal tibia T.

As can be seen inFIGS. 26 and 26A, in an embodiment, the bone-facingsurface324 of the tibialorthopedic implant320 also comprises a plurality of fixation pegs370 (or engagement members) insertable in the tibia through the medial plateau354. The fixation pegs370 penetrate into the medial plateau354 of the resected tibia when the bone-facingsurface324 is abutted thereagainst. In so doing, the fixation pegs370 help to secure theimplant320, to the medial plateau354. Eachfixation peg370 extends away from the bone-facingsurface324 along a longitudinal direction aligned with an axis of the tibia T, when theorthopedic implant320 is implanted thereon. The fixation pegs370 are spaced apart from one another, and can be positioned on a portion of the bone-facingsurface324 that is opposite theflange358. Such a positioning of the fixation pegs370 can provide additional stability to theimplant320 away from theflange358. The fixation pegs370 can have different shapes. InFIG. 26, for example, eachfixation peg370 has a first substantially cylindrical portion extending away from the bone-facingsurface324 which is followed by a conical portion. One skilled in the art will understand that other shapes for the fixation pegs370 are also within the scope of the present disclosure. For example, and as shown inFIG. 26A, each of the threefixation pegs370 can have a ribbed cylindrical portion followed by a conical portion.

In some embodiments, examples of which are provided inFIGS. 26B to 26D, the bone-facingsurface324 can also include a pattern with one or more projections projecting away from the bone-facingsurface324, along a direction aligned with the axis of the tibia T, when theorthopedic implant320 is implanted thereon. Alternatively, the projections can be considered to project inwardly from the bone-facingsurface324. Such projections can be carved into the surface to create a pattern on the bone-facingsurface324. In either case, the pattern can occupy some portion, or all, of the bone-facingsurface324, and provides a medium for bone ingrowth which helps to secure the body322 (and thus the implant320) to the bone tissue to which it is attached. In so doing, the pattern encourages osseointegration, which refers to the direct structural and functional connection between living bone tissue and the bone-facingsurface324 of the load-bearingartificial implant320. The pattern can be a mono-construction and thus integrally formed with theimplant320, or can be added to the bone-facingsurface324 separately. The pattern can also be combined with one or more of the previously-discussed fixation pegs370. The pattern can therefore assume many different configurations in order to provide such functionality. Three possible configurations for the pattern will now be discussed, and it will be appreciated that many other possible configurations are within the scope of the present disclosure.

FIG. 26B shows apattern374 havingmultiple projections376 resulting from a portion of the bone-facingsurface324 having been carved away. Theprojections376 in this embodiment of thepattern374 are expansionary, in that the cross-sectional area of eachprojection376 increases along its length away from the bone-facingsurface324. Consequently, the space betweenadjacent projections376 decreases away from the bone-facingsurface324. A plurality ofingrowth passageways378 are defined between the spaced-apart projections376. The ingrowth passageways378 receive therein living bone tissue from the medial plateau against which the bone-facingsurface324 is applied, thereby encouraging osseointegration with theimplant320. Theexpansionary projections376 therefore define ingrowth passageways that are wider closer to the bone-facingsurface324, and narrower further away from the bone-facingsurface324. The ingrowth passageways378 intersect one another to form a grid-like arrangement. Such a configuration of thepattern374 can be suitable, for example, where it is desired to encourage the grid-like ingrowth of living bone tissue over a significant portion of the bone-facingsurface324.

FIG. 26C shows anotherpattern374 havingmultiple projections376 on the bone-facingsurface324. The bone-facingsurface324 inFIG. 26C has a recessedportion380 from which theprojections376 extend. As with theprojections376 ofFIG. 3A, theprojections376 in this embodiment of thepattern374 are expansionary. Consequently, the space betweenadjacent projections376 decreases away from the surface of the recessedportion380, and theingrowth passageways378 are therefore wider closer to the surface of the recessedportion380, and narrower further away from the surface of the recessedportion380. The ingrowth passageways378 are also disposed in a grid-like arrangement. Such a configuration of thepattern374 can be suitable where it is desired to encourage the grid-like ingrowth of living bone tissue over a significant portion of the bone-facingsurface324 and within the recessedportion380. The osseointegration can therefore occur deeper within thebody322 of theimplant320, which can provide for a more secure attachment of theimplant320 to the bone tissue.

FIG. 26D shows anotherpattern374 havingmultiple projections376 on the bone-facingsurface324. Theprojections376 in this embodiment of thepattern374 are tapered, in that the cross-sectional area of eachprojection376 decreases along its length away from the bone-facingsurface324. Consequently, the space betweenadjacent projections376 increases away from the bone-facingsurface324. The ingrowth passageways378 are therefore narrower closer to the bone-facingsurface324, and wider further away from the bone-facingsurface324. The ingrowth passageways378 are disposed in a grid-like arrangement as well. Such a configuration of thepattern374 can be suitable, for example, where it is desired to encourage the grid-like ingrowth of living bone tissue over a significant portion of the bone-facingsurface324, and where it is desired that the living bone tissue within theingrowth passageways378 expand in thickness away from the bone-facingsurface324.

In light of the preceding, it will be appreciated that many different configurations of thepattern374 are within the scope of the present disclosure, and can be employed with theimplant320, for example, depending on the bone tissue being replaced, the desired extent of osseointegration, and amount of time available for osseointegration.

Now referring toFIG. 30, in an embodiment, thebody322 can also have a retainingrim382. The retainingrim382 helps to secure thebody322, and thus theimplant320, to the tibia T, for example in embodiments where theflange358 covers only a portion of the periphery of the transverse planar section outside of the medial wall. As can be seen, the retainingrim382 abuts against the first retaining surface331 (outer surface) of the tibia T adjacent to the edge of the medial plateau (resected portion) thereof. In so doing, the retainingrim382 overlaps the edge, and substantially reduces or prevents the movement of theimplant320 relative to the medial plateau of the tibia T. The retainingrim382 can be any member extending longitudinally along the Tibia T as a continuous segment along a portion, or all, of the length of thefirst retaining surface331. The retainingrim382 can extend along the entire first retainingsurface331 all the way to theflange358. The retainingrim382 may be raised and thus extend away from the bone-facing surface (not shown) of thebody322. This distance can be constant along the length of the retainingrim382, or can vary to better contour thefirst retaining surface331 of the tibia T against which it abuts.

In the embodiments where thebody322 is semicircular, the retainingrim382 can be an arcuate segment. In an embodiment, the retainingrim382 can correspond to a profile of thefirst retaining surface331 of the bone tissue against which it abuts, at a location adjacent to, and below, an edge of the medial plateau354. This profile can also be arcuate-shaped.

In the embodiment shown, the tibialorthopedic implant320 can be anchored to the tibia T using at least one screw (or attachment device), insertable inapertures372 defined in theflange358, to secure thebase plate340 and, more particularly, theflange358 onto the corresponding bone surface, transversely through theflange358. One skilled in the art will understand that the use of an attachment device, such as the at least one screw, applied to the side of the bone surface, rather than through the top of the bone surface, avoids having to secure the prosthesis to bone tissue which can be damaged or unsuitable for such use. It is appreciated that the number and the shape of theapertures372 can vary from the embodiment shown. For instance, theimplant320 can include one ormore apertures372.

Similarly to the above describedfemoral implants20,120, the articulating surfaces of the tibialorthopedic implants220,320 are also designed to be patient specific. They can be designed to compensate for deficiencies, as described above and as will be described in more details below. The shape of the articulating surfaces of the articulation plates can be designed to reproduce the outer shape of the cartilage of the proximal tibia T, which is superposed to the bone, when imaging is carried out or be an offset of the outer surface of the proximal tibia T. Similarly to the above described embodiments, if part of the cartilage covering the bone is missing or broken, when the imaging of the body structure of the patient is carried out, the articulating surface can be designed to compensate or correct the missing cartilage portion. Once again, the shape of the articulating surface can also be adjusted to correct defaults, for example in the mechanical axis of the patient's leg.

It will be understood, that when a correction of a default is desired, such a correction can be implemented either by a correction of the articulatingsurface26,126 of the femoralorthopedic implant20,120, by the modification of the articulatingsurface226 of the tibialorthopedic implant220,320 or by a combined modification of the articulatingsurfaces26,126,226 of the femoralorthopedic implant20,120, and the tibialorthopedic implant220,320. In the latter case, the desired correction is shared between the articulatingsurfaces26,126,226 of the femoralorthopedic implant20,120 and the tibialorthopedic implant220,320 to reach the overall desired correction.

In an embodiment, the tibialorthopedic implant220 can be anchored to the tibia T using at least one screw for securing theflange258 onto the corresponding bone surface. In an alternative embodiment, to anchor the tibialorthopedic implant220,320, bone cement between thebone facing surface224,324 and the tibia T can also be used. In another alternative embodiment, osteointegration can also be used to anchor the tibialorthopedic implant220,320.

In order to conceive and implant the tibialorthopedic implant220,320, an imaging step of the patient's body structure is first carried out and a three-dimensional image reconstruction of the patient's body structure is performed. A projected resection of the proximal tibia of the patient is determined based on the model obtained by the image reconstruction. The tibialorthopedic implant220,320 is subsequently designed and conceived with theflange258,358 having aninternal surface260,360 matching the shape of the patient's unresected bone and the transverseplanar section250,350 and the sagittalplanar section252,352 corresponding to the projected resected sections of the proximal tibia. The articulatingsurface226 is also designed to be patient specific and can compensate for deficiencies or defaults, as described above.

Therefore, before the implantation can be performed, the proximal tibia T must be resected according to the projected resection in order to be prepared to receive the tibialorthopedic implant220,320. The design of the present tibialorthopedic implant220,320 allows the resection to occur without having to cut the anterior cruciate ligaments. The resection can be performed using known resection methods and tools to perform the projected resection, and should result in themedial plateau254,354 andmedial wall256,356 precisely matching the transverseplanar section250,350 and the sagittalplanar section252,352 of theorthopedic implant220,320 to be implanted.

Several alternative embodiments and examples have been described and illustrated herein. The embodiments of the invention described above are intended to be exemplary only. A person skilled in the art would appreciate the features of the individual embodiments, and the possible combinations and variations of the components. A person skilled in the art would further appreciate that any of the embodiments could be provided in any combination with the other embodiments disclosed herein. It is understood that the invention can be embodied in other specific forms without departing from the central characteristics thereof. The present examples and embodiments, therefore, are to be considered in all respects as illustrative and not restrictive, and the invention is not to be limited to the details given herein. Accordingly, while specific embodiments have been illustrated and described, numerous modifications come to mind without significantly departing from the scope of the invention as defined in the appended claims.

Claims (19)

The invention claimed is:

1. A tibial orthopedic implant for implantation onto a proximal tibia of a patient's knee joint, the proximal tibia having a longitudinal axis, a bone surface with a resected bone section including a medial plateau and a medial wall extending upwardly from the medial plateau, the tibial orthopedic implant comprising a body having a bone-facing surface including a transverse section superposable to the medial plateau and extending substantially normal to the longitudinal axis of the proximal tibia and a sagittal section engageable with the medial wall with an acute angle being defined between the transverse section and the saggital section to provide a vertical substantial retention of the tibial orthopedic implant on the proximal tibia.

2. The tibial orthopedic implant ofclaim 1, wherein the acute angle between the transverse section and the sagittal section ranges between about 75 degrees to about 89 degrees.

3. The tibial orthopedic implant ofclaim 1, wherein at least one of the transverse section and the sagittal section is substantially planar.

4. The tibial orthopedic implant ofclaim 1, wherein the body further comprises at least one fixation peg protruding downwardly from the transverse section.

5. The tibial orthopedic implant ofclaim 1, wherein the bone-facing surface of the transverse section comprises a generally flat profile with a 3D pattern protruding therefrom.

6. The tibial orthopedic implant ofclaim 5, wherein the 3D pattern comprises expansionary projections defining ingrowth passageways inbetween.

7. A tibial orthopedic implant for implantation onto a proximal tibia of a patient's knee joint, the proximal tibia having a bone surface with a resected bone section including a medial plateau and a medial wall extending upwardly from the medial plateau, and an unresected side surface extending downwardly from the medial plateau, the tibial orthopedic implant comprising a body having a bone-facing surface including a transverse section superposable to the medial plateau, a sagittal section engageable with the medial wall, and a substantially U-shaped flange and a retaining rim, spaced-apart circumferentially from the U-shaped flange, the U-shaped flange and the retaining rim extending downwardly and inwardly from the transverse section and engageable with the unresected side surface of the proximal tibia and substantially conforming thereto.

8. The tibial orthopedic implant ofclaim 7, wherein the unresected side surface of the proximal tibia is cartilage free and the U-shaped flange and the retaining rim substantially conform the unresected and cartilage free side surface of the proximal tibia.

9. The tibial orthopedic implant ofclaim 7, wherein at least one of the transverse section and the sagittal section is substantially planar.

10. The tibial orthopedic implant ofclaim 7, wherein the body further comprises at least one fixation peg protruding downwardly from the transverse section.

11. The tibial orthopedic implant ofclaim 7, wherein the bone-facing surface of the transverse section comprises a substantially flat profile with a 3D pattern protruding therefrom.

12. The tibial orthopedic implant ofclaim 11, wherein the 3D pattern comprises expansionary projections defining ingrowth passageways inbetween.

13. The tibial orthopedic implant ofclaim 7, wherein the substantially U-shaped flange comprises at least one screw-receiving aperture extending therethrough.

14. The tibial orthopedic implant ofclaim 7, wherein the retaining rim is free of screw-receiving aperture.

15. A tibial orthopedic implant for implantation onto a proximal tibia of a patient's knee joint and including an unresected and cartilage-free side surface extending downwardly from the medial plateau, the proximal tibia having a bone surface with a resected bone section including a medial plateau and a medial wall extending upwardly from the medial plateau, the tibial orthopedic implant comprising a body having a bone-facing surface including a transverse section superposable to the medial plateau and a sagittal section engageable with the medial wall with an acute angle being defined between the transverse section and the saggital section to provide a vertical substantial retention of the tibial orthopedic implant on the proximal tibia and wherein the body of the tibial orthopedic implant further comprises a flange extending downwardly and inwardly from the transverse section and engageable with the unresected and cartilage-free side surface of the proximal tibia and substantially conforming thereto.

16. The tibial orthopedic implant ofclaim 15, wherein the flange is substantially U-shaped.

17. The tibial orthopedic implant ofclaim 15, wherein the body further comprises a retaining rim extending downwardly and inwardly from the transverse section and engageable with the unresected and cartilage-free side surface of the proximal tibia and substantially conforming thereto, the retaining rim being circumferentially spaced-apart from the flange.

18. The tibial orthopedic implant ofclaim 15, wherein the flange comprises at least one screw-receiving aperture extending therethrough.

19. The tibial orthopedic implant ofclaim 15, wherein the flange comprises at least one screw-receiving aperture extending therethrough and the retaining rim is free of screw-receiving aperture.

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